Elsevier

Burns

Volume 42, Issue 1, February 2016, Pages 13-19
Burns

Review
Critical care of burn patients. New approaches to old problems

https://doi.org/10.1016/j.burns.2015.04.009Get rights and content

Highlights

  • New publications on critical care change our beliefs.

  • There is no benefit in trying to interfere with early catabolic response.

  • Parenteral nutrition is a safe and effective method of nutritional support.

  • Fluid resuscitation guided by lactate levels is safe.

  • There is limited evidence that specific interventions decrease mortality in ARDS.

Abstract

Recent publications on treatment options in critically ill patients change beliefs and clinical behaviors. Many dogmas, which the modern management of critical illness relies on, have been questioned. These publications (consensus articles, reviews, meta-analysis and original papers) concern some fundamental issues of critical care: interventions in acute respiratory distress syndrome (ARDS), hemodynamic monitoring, glucose control and nutritional support and revise our views on many key points of critical care of burn patients.

Section snippets

Glucose control

Acute illness is accompanied by the development of abnormal physiology which the clinicians monitor and attempt to correct believing that rapid correction and reversal of pathophysiological states will help to better patient outcomes. The pathophysiological changes, however, reflect the severity of the situation and their correction to perfectly normal levels does not always coincide with patient recovery. The concept of tight glucose control in critically ill patients could be mentioned here

Hemodynamic monitoring

Treatment based on physiological monitoring, has been a cornerstone of teaching in critical care medicine for decades. Disease severity has been believed to be an important indicator of outcome, and the assessment of severity has been largely based on the degree to which the measured variables (e.g., perturbations of the cardiovascular, respiratory, and acid-base systems) differ from normal values. Established data have documented a close association between the sequential changes in

Conflict of interest statement

There is no any conflict of interest to declare.

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